Test Readings and Dosing

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rvontrapp

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Is there only one type of PZI insulin? ProZinc and PZI are the same thing, right? I've read several forum threads and researched on the internet a little, and it sounds like there are different knids of PZI insulins, and that the different kinds behave differently when dosing. And, different dosing protocols. I really thought there was only one PZI insulin! I'm trying home testing again and I was trying to learn a bit about the insulin we use, but I'm feeling more mixed up than before.

Most importantly, I need to know what to do when/if I get a low reading. Munchkin has been diabetic for a couple years and we've had enough hypo incidents that I'm properly scared of having another. Haven't had any in months and have been giving 2u twice a day with no pre-dose testing. So, if I start testing . . .
*What are low and normal readings?
*If I get a low reading, what do I do? Do I reduce the dose, or not give the dose at all?
*If I get a "normal" reading, what do I do? Ditto, reduce the dose or no dose?

I haven't tried to set up a spreadsheet yet or a profile, but I will. I just figured out how to edit my signature. :?
Thank you for all your help!
 
There are different types of PZI but all are dosed the same. Originally it was called PZI and then they changed the formula and called it ProZinc. You can also get a compounded product still called PZIBCP. But for our purposes, we just say PZI.

If you want help, I can set you up with a spreadsheet. I will send you a private message. Watch at the top of the page for "1 new message" it is so much easier to keep track of your progress with a spreadsheet.

How can we help you with the testing? It is really the safest and easiest way to manage this sugar dance.

Generally, we ask new diabetics not to shoot under 200 but to wait 20 minutes (without feeding) and retest. You want to make sure the number is rising, not falling and that it is over 200. Food raises bg levels and we want a true number, without the food rise.

Regulated cats run in the lower 200s at preshot and 100 and under at midcycle, but not lower than 40. (40 is time to intervene with food and possibly sugars). A cat is in remission when they range from 40-120, off insulin, for 2 weeks.

This forum is small and friendly, busiest in the early am and later pm. Be patient waiting for a reply. If you ever need immediate help, head over to Health. It is busier.
 
Thanks Sue,

I've posted before in the Health forum and everyone has been great! I'll post there again if I ever have soemthing urgent. They gave me some links so I could "study up" on home testing, and I have been. :) One link had tons of tips on how to get a good sample for testing, and I hadn't know any of that stuff before. So, I feel like I could give this home tesing another try and it might actually work, if I use some of those tips. We're going to try again tonight.

So, if I test and get a value over 200, then I dose like I normally would.
But, if I test and get a value at or under 200, then do nothing and wait 20 minutes to retest.
If at the retest it is still at or under 200, then no dose.
If at the retest it has risen (even if just a little), then give the whole dose.
Right? Please let me know if any of this is wrong.

Wait, I am using a human meter; is the 200 value true if I use a human meter? I mean, I'm not sure if it is 100% accurate for a cat. Should I correct the value it gives me to account for the fact that I am testing a cat and not a human?

(I got your PM and will PM back about the SS in just a minute.)

Thanks Sue!
 
The only adjustment is the normal dose if over 200. If he is lower than 200 at preshot and you do the 20 minute thing and he is over by a little but not a lot, you would probably adjust the dose down a little, at least in the beginning until you have good data on his patterns. If he is under 200 at preshot, we could "assume" that he went down lower during the cycle. (unless we have the data that says he didn't go too low).

Ideally we want a shootable number at preshot and a safe but nice midcycle number. We adjust trying for that ideal.

You can read our PZI document:

http://felinediabetes.com/FDMB/viewtopic.php?f=24&t=32799

It has lots of good info and links.

And take a look at other people's spreadsheets and threads. Although no two cats react the same, their journey of doses and history will give you good info on how things might go.
 
Wait, I am using a human meter; is the 200 value true if I use a human meter? I mean, I'm not sure if it is 100% accurate for a cat. Should I correct the value it gives me to account for the fact that I am testing a cat and not a human?
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Yes that would be 200 on a human meter. By default we talk in terms of what you would get testing with human meters. Probably 95% or more of us on the board use human meters.
As far as accurate.... they are accurate enough for what we are using them for. They tend to read a little lower than "vet meters" but that is fine.
All meters, no matter what type, are allowed to be off by as much as 20% plus or minus, and meet FDA approval. So really you could say "they're close enough for government work" ;-)

And no, you don't adjust the number because it's being used on a cat. With a human meter, a blood glucose value between 40-120 is "normal" for a cat. That's what you'd see on a cat that didn't have diabetes, or is in remission.
 
Ok, so 40 - 120 is "normal", or normal enough, whether that's remission or results from a non-diabetic kitty.

If he is under 200 - I wait 20 minutes and retest - if it is only barely over 200 at the retest, then I could give maybe 1u instead of 2u? Or 1.5u? (just for right now, until I have a record of test results)

Sorry if i am being a little too specific, and we don't even have a recent test value yet! Its just we don't have internet access at the house and I am just trying to make sure I have a good game plan for whatever number the meter spits out.

And, YES, I am totally okay with "assuming" he went lower than his pre-shot number during his cycle! Not knowing his low, mid-cycle numbers is how we got so many hypo episodes, too many, and siezures.

Of course I'll be reading up on the PZI document and other people's threads. The more info, the better! :) Thanks!

(And Carl, love your signature tag line! When you find a bacon tree, please let me know so I can plant a few.)
 
And Carl, thank for including the bit about human meters reading low on cats. If I didn't know that I'd probably flip out when/if I ever get a 50 or 60 reading, even though I now know above 40 is okay for a cat. (50 or 60 is hypo danger in a human) Thanks again!
 
If it is 205 after the 20 minute period, you could reduce to 1.5 because it means he is only rising slowly. But we will have a much better idea after we see your spreadsheet numbers and you get some data. It is hard (and a little scary) to do hypotheticals for dosing until you have some history. You might get one of our email addresses or phone numbers if you don't have internet at home. Then we could post for you on the forum, get some input and email or call you back.

Many PZI users use U100 needles and the conversion chart ( Conversion chart) Then you can shoot 1.2 or 1.4 instead of eyeballing 1.5 The conversion chart is necessary because you are using a U40 insulin with U100 needles.
 
Ok, I got the spreadsheet and I'm looking it over. Thanks Sue!
I would like to get a phone number or two if someone is comfortable with that. Maybe PM the info to me?
 
Well, I gave home testing another try last night. Munchkin's PMPS was 314 and we gave him his 2u like usual. I don't know how fast a cat's blood sugar can rise but we ran the test after several minutes of wrestling about and while I gave him about 20 - 30 Greenies. I'm pretty sure the Greenies aren't low carbs but my low crab treats haven't arrived yet. I think warming his ear helped a lot. I had never done that before when we tried to test.

I tried testing again two hours after dosing (I figured more practice would be good for both Munchkin and myself). Of course, that required another 20 or so treats, but all-in-all it didn't go so well. More wrestling and the kitty burrito completely fell apart; I got a couple scratches. I botched using the lancet. I used the lancet pen (it worked ok the first time and I first testing it on myself multiple times to get the depth correct) but I pushed it too hard up to poor Munchkin's ear. The lancet poked all the way through and I forgot to use a tissue to hold his ear and poked my finger too. And, I had ointment on his ear to help the blood drop bead up, but I didn't have enough on him and all the blood just soaked into his ear fur. Uugh! It was like a bad comedy of errors.

So, I didn't get any results from our second attempt. Munchkin was very forgiving though, which is remarkable considering how grumpy he always is. He did seem excited about getting extra treats. So excited that after I turned him loose, he hung around insteading of running to hide. That's promising, right? And, he didn't cry either. He growled and hissed and threw a little tantrum, but no crying.

I'll PM Sue here in a minute and see if she can help me add Munchkin's spreadsheet to my signature. I only have the one test result in it. I called the vet yesterday to see if they'd send me some past results (so I could load those too). They said they'd send them but I haven't gotten them yet. I'll call them today about it.

I did some more reading on the PZI/ProZinc insulin. As I understand it the ProZinc insulin is a manufactured human insulin. It is not designed for cats but is one of the most common to give to cats for diabetes treatment & management. The BCP PZI insulin is a bovine insulin, more similar to feline insulin and can sometimes give better control in cats than the ProZinc human insulin. But, it was/is only available from one suppier in Texas. Does anyone here use it or know someone who uses it? The manufacturer's website (glorified commercial) claimed you could get as good results or better results with only once-a-day dosing. I'm not changing insulins or anything like that. Just trying to learn.
 
First, welcome to the Vampire Club and congrats on a successful test! We found it easiest to take the clear cap off the lancet device (if yours has one). Also, just a tiny smear of Neosporin is best. Too much and it throws off the sample. 314 is a reasonable amps. Any chance you can get a midcycle number? That would give us an idea how low 2 units takes him.

Yes, the greenies are high carb. Does he like tuna or chicken? You can give a few pieces of people tuna (packed without oil) or cooked chicken with no spices (cut into tiny pieces) until your other treats arrive.

We have had people use BCP PZI. I don't think there is much difference in results. Some people don't like that it is compounded, as the batches are not always consistent. Once a day dosing is not recommended; the insulin tends to last only 12 hours so the cat is on a roller coaster - 12 hours with good numbers and then 12 hours with high ones.
 
Can you give me more details about removing the clear cap off of the lancing device? The link below will take you to a picture of the device I am currently using; it came with a blue cap (shown in the picture) and a clear cap. You can't really operate it without one of the two caps in place. Were you talking about using the blue cap instead of the clear cap?

http://www.medicalexpo.com/prod/lifesca ... 56784.html

I noticed I am still poking all the way through his ear with the lancet. :? It has the adjustible depth so I'll dial it back a little at a time, but it doesn't cause a problem if it happens now and then until I get the depth correct? Right?

I do use the little smear of neosporin ointment (plus pain relief). If I don't use it then I loose the blood drop in all his ear fur, if I don't use the ointment to slick down the hairs a bit. Someone mentioned on another thread that you could shave their ears, just until the human tester got the hang of it, but I don't think I'm ready to try that.

Thank you also for the info on the BCP PZI insulin.
 
Ok, now I feel like celebrating! We tested last night without too much hoopla. :-D I'm not sure what was the deciding factor that made this experience less tantrum inducing, because we did a couple things different. First off, he had already been fed (I got home late) so he wasn't cranky with having to wait for his dinner. And since he had already been fed and had his shot, I didn't feel the need to test his sugar "right now" because dinner time & shot time had already passed. I saw where someone else on the PZI forum has been using just tiny spoonfuls of food as a "treat" at testing time, so I tried that too instead of the Greenies. I got everything ready ahead of time (food, lancet device, meter, etc) and then just sat back and waited; no hurry because he'd already eaten. He came to investigate and we had our evening snuggle. It seemed like he was expecting his treats that he had been getting the last three days. He still doesn't like his ears being fooled with and got up and left several times, but kept caming back. I quit trying to warm his ears, and did everything else in pieces with snuggles in between. It took waaaay to long from start to finish, but I got a reading without a tussle! :smile: Maybe he'll get more used to it with time and it will all flow smoother?

I still want to try for a curve this weekend, or at least have more tests than just one or two a day. It seems easier to test when Munchkin isn't excited because its feeding time. I know that won't work in the long term, or really in the short term either. We need pre-shot numbers. Right now we don't have a routine snuggle time in the morning (normally I'm in a rush to get ready for work) but maybe I need to make it a habit? He has always been a prickly cat, "don't touch my belly, or my butt, or the lower half of my back", "don't pet me too long, or you petted me too long and didn't stop soon enough".
 
Also, we're getting the larger lancets and a new meter today. Planning on getting one of the ReliOn meters that requires less blood than what I am currently using. I'm really not a fan of Wal-Mart and we never go in there but everyone seems to have good things to say about the ReliOn so I'm willing to make the trip and give it a try.
 
rvontrapp said:
He has always been a prickly cat, "don't touch my belly, or my butt, or the lower half of my back", "don't pet me too long, or you petted me too long and didn't stop soon enough".
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Sounds like a normal cat to me.... :mrgreen:

Ideally, you want to test before he eats so the number is not influenced by food. This particularly becomes an issue if you would get a number under 200. In that case, you'd be wondering whether to shoot and whether to reduce and you wouldn't be able to get a test not influenced by food for 2 hours (when the food had worn off)

But life is not ideal. Nor are cats....Could you give him a few teaspoons of food and let him eat that and then test? (a few teaspoons might keep him happy for the few minutes it takes to test). Could you test within 15 minutes of his eating. (this is not fool proof. Every cat reacts differently to food, but generally we think it takes the food that long to impact numbers). You could look at feeding him 2 hours before the shot time (automatic feeders are great for this) and then having your cuddle time when you wake up.

The best plan is to figure out a routine that will work for you both that will allow a test before or shortly after eating. The truth is once you establish a routine that involves some treats and some food, they will go along. It might take a while but they usually give in.

I hate Walmart too. Haven't shopped there in 20 years. Hold your nose this time. From now on, you can buy the strips through the Diabetics Warehouse and help FDMB out. Just ask about it on Health.
 
As I understand it the ProZinc insulin is a manufactured human insulin. It is not designed for cats but is one of the most common to give to cats for diabetes treatment & management.
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That's not quite correct. Prozinc is made from human insulin. It isn't used by humans. It is genetically engineered to be "more like" feline insulin, and is only used for cats. It was invented when it was clear that they would no longer be producing PZI Idexx which was made from the pancreases of pigs and cows.

Compounded insulin is "cow-based", made from cow parts. For some reason, the supply of pigs parts disappeared and they no longer make it using both.
 
That is really great news that I can get the strips from Diabetics Warehouse and don't have to go back to Wal-Mart. I love my Big Boy Munchkin so if I had to go to Wal-Mart every now and then, I would do it. But, I'm glad I won't have to!

Those are some good ideas about tweaking the timing of the feeding and the testing. Do you suppose I could try to test while he is eating? We currently give him his shot while he is eating and he just ignores us. I could try slipping the test in right before I shoot. When we first started doing insulin shots, he hated it, but he didn't hate it enough to leave the food bowl to get away. If that doesn't fly, I can always try testing right after he's eaten a partial portion, the few teaspoons (within that 15 minute mark).

We'll get a routine before long and this will work!
 
FYI. Rebekah does not have Internet access on the weekends. MUnchkin was 230 at pmps and she gave 2 units. This morning at amps he was 90; 2 hours later 85. I encouraged her to keep an eye on him. Tonight if he is over 300, she is thinking 1-1.5 units and plans to monitor.
 
Sue
Was the +2 today with or without food? Either way, interesting that at +14 he was in greens. She skipped, right?
 
I don't know about the food, Carl. Yes, she skipped this am. Interesting because he has been on insulin for more than a year. But I think she did just start wet low carb.
 
I know AMPS was high b/c M. was very thirsty & peeing a lot; I was late getting home so my husband fed M. & gave shot b4 I got home
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(comments from the SS on the 4th.)

Still drinking and peeing excessively.... was this just an off day, or is that "normal"? Hopefully the switch to low carb wet will help, and it should reduce the drinking a lot since he'll be getting enough (theoretically) hydration from the food. If he continues drinking a lot after he's used to the canned food, I'd be thinking "dehydration" or maybe something going on with the kidneys/urinary tract.
 
Munchkin continues to be challenging, but in an encouraging way.. The amps was 263; she gave 1.5. Nadir was 162. But DH felt he was starving at 11.5 :mrgreen: and fed him. So the pmps was food influenced and was 242. 20 minutes later 230.

Rebekah and I discussed options: skip overnight, wait 2 hours and give a smaller dose, wait 2 hours and give a regular dose but think about reducing in am because amps will be 2 hours early. She is going to decide based on his number in 2 hours.

This is difficult because she has no Internet at home, so no way to post on weekends and she can only post at work, after she has given insulin in the am. Suggestions anyone?
 
Good Morning!

Well, we got several readings this weekend, now to make sense of it all! On Friday I did get the ReliOn meter without too much trouble. On Friday night we tested on time and got 233, and Munchkin got fed on time too. I was so focused on trying to work the meter and get him fed that I didn't realize until later that we hadn't given Munchkin his shot, so he got his shot 2 hours late Friday night. I felt 233 was high enough for his regular shot (2u) and didn't think another thing of it until his AMPS was 90, and later 87 (after a 15 minute wait).

So, no AM shot on Saturday morning. It was kind of dissappointing for me since I had planned to do a curve on Saturday (our only chance for the next two weeks) and now the curve wouldn't even be representative of a normal day. But, I needed the practice at testing so we did the curve anyways. At +1 Munchkin was 129 and by +2 he was 281, so his sugar went up and stayed up, just like we expected. (BTW - we feed Munchkin twice a day so it was +1 from feeding time since no shot on Saturday morning, +2 from feeding, etc.) The rest of the morning and afternoon was 313 at +4, 285 at +6 and 347 at +9, and we fed him and gave him his shot (1.5u) at +9. We gave 1.5u for PM shot in an effort to be conservative (versus 2u). Our rationale: we had no real long-term data to go on but we thought he probably went too low Friday night/Saturday early AM and better to have the sugar run a little high than too low, again. At +2 from Saturday PM shot he was 266.

Sunday morning his AMPS was 263 and gave 1.5 (with feeding). +6.5 was 162, probably nadir. All-in-all it was a good day and Munchkin was feeling lovey-dovey. I left for church in the evening, all is well, and then later my husband feeds Munchkin 30 minutes too early (I wasn't home and Munchkin puts on a good "starving kitty" act). My husband, however, didn't give Munchkin his shot. We had talked about how Munchkin shouldn't get his shot until after he had been tested. So, Munchkin was fed at +11.5 w/o shot and I tested him at +12 (30 minutes after feeding) and he was 242. I didn't give him his shot; Sue and I had talked that if he was between 200 - 250 we would hold the shot and retest to make sure the sugar was rising. So, at +12.5 I tested Munchkin again (1 hour after feeding) and he was 230; he went down a few points.

Talked to Sue again. Decided to test again 2 hours after feeding, after the food has finished influencing the BS numbers. At +13.5 since AM shot and also 2 hours after feeding, Munchkin was 239 - still hovering around the same numbers (242, 230, 239). I didn't want to end up in the same pickle I had been in Saturday morning where he got super-low during the night, so I didn't want to give 2u, or even 1.5u. But, I didn't want to skip the dose entirely especially since he's been getting 2u twice a day for months and months. Decided to give a reduced dose of 1u. This morning AMPS was 374 (+10 since PM shot) and gave 1.5u.

I can't begin to predict what his BS numbers looked like in the night. Maybe the 1.0u was too much for a PM shot with pre-shot values of 235-ish and he bounced up this morning? (But, he's been getting 2u twice a day for months.) Or, maybe the 1.0 wasn't enough and it rose throughout the night? Or this is just normal for Munchkin - he has a habit of giving his highest BS numbers first thing in the morning, always has, unless something is wrong.

He never has given a number breaking 400; his highest numbers have been in the 300s but most frequently in the 200s. However, we haven't been testing at home, just at the vets so that really isn't all that many data points. He's been diagnosed for a little over two years and we've been giving low-carb (<6% carb), wet food for about a year-and-a-half. It has worked well for us; no complaints. I can't say if it has reduced his need for insulin. We made the switch to the low-carb, wet food while he was still unregulated and the vet (and me too) had high hopes he could be diet controlled, but that didn't materialize. So, still didn't have his sugar down enough so we kept increasing the insulin over the following couple months. He was overweight so we worked on some weight loss too. When we had success with the weight loss, that is when he soon after starting having seizures and hypo episodes.

Mild at first but got more severe over many weeks, a couple months. Had a bad one on a Saturday morning and I called the vet on the emergency line. That time we recognized it as hypo and seizures. I love that vet; he called us back right away. We had already given Munchkin some food to help him recover and the vet said to reduce the insulin dose and come in for BS tests. I think that was in June and thats when we took him in for the June 2012 BS tests that you can see on his spreadsheet. His numbers were okay enough that the vet said to keep him on the new, reduced dose. (I think that was the June 2012 BS test but I'm not 100% sure.) He'd been on the flat insulin dose (with no home testing, just periodic tests at the vet's office) for many months and he'd been on the low-carb food for many months; the weight loss was the only change - healthy weight loss. We'd been slowly cutting back on how much we fed him and he lost the weight over several months (9 months?). The vet was happy with the pace. Munchkin had always been a little overweight.

Munchkin still acted odd at times and this time I recognized the hypo symptoms. That is when we went back for more BS tests over August through to November. He was going hypo and the vet kept stepping down the insulin dose until we were at 2u twice a day, and that is what we have been giving him since November - 2u twice a day. (His dose had been as high as 5 or 6 units twice a day.) I haven't seen any more hypo episodes but that doesn't mean he hasn't had them. After this weekend, I'm sure he's had them, just not the pronounced symptoms, or not while we're around.

Protocol, I need one. I know I don't have much data to work with, but I need some kind of protocol to go by for the next two weeks and to give the catetaker this weekend (we're going out of town.) (BTW - still need to find a cartaker for this weekend.) We've stepped his dose down from 2u twice a day to 1.5u twice a day, after this weekend's readings. So, I'm thinking 1.5u as long as pre-shot is over 250? If its between 200 - 250, then wait, retest and see if it is rising or falling. But what then? If it is below 200 then hold the dose? What do ya'll think?
 
Sorry, forgot to add something.

That Thursday morning (4/4/13) when I couldn't get Munchkin to cooperate to get a reading but I commented "I know AMPS was high b/c Munchkin was very thirsty & peeing a lot", for Munchkin that was out of the ordinary. We've been doing wet food for a while and he rarely drinks all the water in his bowl, but he did that morning.

I had been trying to test him over the past couple of days (and we hadn't been in the habit of doing bs tests at home) and he'd get mad and worked up, and I think that is why those readings that I could get in the evenings were so high - I stressed him out & the bs would rise. At least, that's my theory. And, I think that is why he was drinking and peeing so much that morning, I stressed him out trying to test and his bs shot up. Possible?
 
I am thinking one unit between 200-250, if he is sure rising - unless he throws us some lower numbers this week. And under 200. That's a hard one. If you had some data and were able to monitor, you could try a small dose. But I think it is too soon to consider that.

As far as stress of testing causing higher bgs. My theory is always, he's a cat and anything is possible. :mrgreen:
 
Hi Rebekah,

I wanted to say "thanks" for the post you made earlier today. It contains lots of "background" information, and it'll probably be tomorrow before I can attempt to respond to at least parts of it. ;-)

I did want to say that I agree with your logic and your instincts on dose here:
Talked to Sue again. Decided to test again 2 hours after feeding, after the food has finished influencing the BS numbers. At +13.5 since AM shot and also 2 hours after feeding, Munchkin was 239 - still hovering around the same numbers (242, 230, 239). I didn't want to end up in the same pickle I had been in Saturday morning where he got super-low during the night, so I didn't want to give 2u, or even 1.5u. But, I didn't want to skip the dose entirely especially since he's been getting 2u twice a day for months and months. Decided to give a reduced dose of 1u. This morning AMPS was 374 (+10 since PM shot) and gave 1.5u.

I can't begin to predict what his BS numbers looked like in the night. Maybe the 1.0u was too much for a PM shot with pre-shot values of 235-ish and he bounced up this morning? (But, he's been getting 2u twice a day for months.) Or, maybe the 1.0 wasn't enough and it rose throughout the night? Or this is just normal for Munchkin - he has a habit of giving his highest BS numbers first thing in the morning, always has, unless something is wrong.
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I think the reduction was a good choice, and I'd give that dose a try for a couple of days to see what kind of numbers you get.
 
Good Morning!

I did get a little bit long-winded yesterday (and honestly, every other time too), but I wanted to give as much background information as I could. I figured it would be better for me to get it all out there rather than ya'll have to ask 20 questions just to know where we stand right now. Thanks Carl for understanding and I look forward to any insight you can give.

I updated Munchkin's spreadsheet with his numbers. PMPS last night was 240, and then 15 minutes later was 224. I agree with Sue that if Munchkin tests in that borderline range 200 - 250 and he is rising, to give a reduced dose of 1.0u. But since he was in that borderline range and falling, I chickened out and gave just 0.5u. Do ya'll think that was the right dose? And, is that one of those times I should have called you, Sue?

This morning Munchkin's AMPS was 391, and that may be the highest bs test result I have seen from him, ever. I gave 1.5u, and of course, fed him and the girls (Fiona and Pageant). We feed them twice a day and the times revolve around when Munchkin gets his insulin shot. If I forget to sometimes say we fed them at Munchkin's shot time, it is safe to assume we fed them. They are all very vocal a feeding times and missing a meal would just not fly, period.

So, 2u took Munchkin too low on Friday night, and 0.5u gave us our highest reading ever.
 
.5 might have been a little too little, but it's overnight and it is always better to be too high than too low. Next time, you'll know you can be a little braver. It would be really nice if you could get some U100 needles and use the conversion chart. Then you could have given .6 or .8 and it might have kept him lower.

There is NEVER too much information. :mrgreen:
 
Good Morning!

PMPS was 236 and I gave 1.0u. I didn't wait and retest in 20 minutes, thought about it but didn't do it. Even if it had been rising I wasn't feeling too comfortable with giving 1.5u. I did get a +2 bs value of 176, and then I got a little worried. 162 was nadir over the weekend, and +2 is nowhere near nadir and I already had a reading of 176. PM+2 is normally right at our "bedtime" and it was last night too. Munchkin, my husband and I retire to the bedroom (at +2) and M. normally gets some 2-on-1 attention from me and my husband. We actually go to sleep an hour or 1.5 hours later. But, last night Munchkin was not having the snuggles. It was warmer than normal in the house (80+ degrees, A/C was on the fritz) and that could explain the antisocial behavior - too hot for snuggles. But, I was worrying his sugar was too low. I'd been worrying too much all day, so I refused to give in to the worry and get up and test again. Even when I didn't fall asleep for 3 hours, I still didn't get up to test. So, naturally, like an idiot, I've reinforced my worries by leaving it an unknown. :roll: I should have just gotten up and tested him. I was already disturbing him by checking on him off and on. I could hardly tell if he was breathing, but he was and I just kept waking him up to check.

This morning was better. AMPS (was at +11) and was 290. Munchkin was complaining rather loudly that he was ready for breakfast NOW! So, I caved, fed him and dosed him with 1.5u since it was high enough. And, since he ate early it gave me the chance to get one more reading before leaving for work - 273 at +1. I needed him to eat early anyways since we will need to feed earlier tonight too; now it will work out to +12 tonight. He was himself this morning. Bright eyed and bushy tailed, and grouchy! He was looking for ways to pick on the girls without having to put too much effort into it, just to entertain himself. Very normal behavior for him. So, I'm not going to worry today, absolutely not.
 
Aah, the trials of being sugar parents. Looks like it came out alright. He is getting good numbers - just a fraction lower and we'd consider him regulated.
 
Yes, it worked out just fine. :smile: Now that I can actually get him to cooperate with bs testing, I want to get tons of readings during the cycle to see how low he is going - but can't, not with our schedule for the next week and a half. But, no worrying! You are right, these are good numbers. I should be happy, and I am.
 
I forgot to bring Munchkin's meter with me today so I updated his spreadsheet the best I could from memory. I couldn't remember last night's reading, other than it was unremarkable. This morning though, now those numbers I remeber: 183 & 191 (or within a few points). I know we said I wouldn't dose if it was under 200, but it was so close to 200 and rising that I didn't want to give him nothing, so I did give a dose of 0.5u. That was probably okay, right?

Munchkin's new treats arrived yesterday: freeze dried beef liver and freeze dried baby shrimp. All three kitties love the liver, but Munchkin is the only one who likes the shrimp (which is actually very handy since he is the only one getting bs checks.) Poor special Fiona got the liver stuck to the top of her mouth or in her throat; when that extra dry treat touches a mucus membrane it sticks. She didn't choke, but close. It took her a minute to get it unstuck and I got a little worried. The treats are about 3/4" cubed out of the package. Should I cut them smaller? Or would that just make them the perfect sticking/lodging/choking size?
 
Forgot to mention, Fiona is retarded. We got her as an older kitten, a stray, so we don't know if she was born that way or if something happened. I'm not trying to be mean or anything, she just doesn't get some stuff. But she is the sweetest, neediest, lovey-dovey cat I've ever met.
 
Good morning, Rebekah,

The .5 sounds fine for today. If you were going to be home and could monitor, 1 unit would probably have been okay. But I appreciate that not being able to watch makes it hard to be a little more aggressive. I can't remember. Do you have the U100 needles? If so, you could have done a little more like .6 or .8 If not, would you like to get some for those smaller measurements? I think they come in bags of 10 for little cost. You want the ones that measure 1/2 units. Sometimes you have to ask the pharmacist. If you do go that route, you have to use the conversion chart, as you are using U100 needles with U40 insulin:

Conversion chart

Glad that Munchkin likes the seafood treats. Yes, cutting them up for Fiona would probably be good. She sounds like a sweetie.
 
Ok, I loaded in all Munchkin's bs readings: 312 the night before last (Wednesday night), 182 & 191 yesterday morning (Thursday morn), 293 last night (Thurs Night) and 269 this morn (Friday). I was very pleased that PMPS last night was only 293 after giving 0.5u in the AM, a whole 100 points lower than the last time he got 0.5u earlier in the week! (that was on 4/9/13 when he got 391 for AMPS following 0.5u dose)

I don't think I am grabbing at straws, but I admit I could be. Almost the exact same thing happened the two times when he had the reduced dose of 1u.
4/7 PMPS =236, gave 1u, following AMPS =374
4/9 PMPS =236, gave 1u, following AMPS =290 (of course it was at +11 and not +12)
But, it was 84 points lower the second time around. :smile: I can't help but be happy! Even if these are just straws, I like my straws!

I think Munchkin is getting used to getting a bs check at +2 in the evenings right before bed. He came and pesterd me last night, meowing and being underfoot. I had no intention of testing him (all the bs readings looked fine) but then I tested him anyways to make sure nothing was wrong. He didn't give me much warning when he's gone hypo before, but insistent, harsh meowing was one sign, the only sign really. And nothing was wrong, bs of 285 (PM+2). All he wanted was a little bedtime snack, that sneaky cat!

Sue, I don't have any of the u100 needles, but I'm thinking more and more that I might need to get some. We are going out of town this weekend but I'll get some when we get back. I've got the conversion chart and it looks pretty straightforward. I'll just have to have my wits about me (& not be half-asleep) the first few times I use it.

Had to board Munchkin for the weekend, and he does fine with boarding, but I'm still worried, but trying not to be. Its a different vet; we haven't been there in so long that they had all of Munchkin's records in storage and unaccessable. And, they haven't seen him since he was diagnosed diabetic. I took in instructions, supplies, hypo food and corn syrup; and talked to the vet briefly about the history of hypo episodes and seizures and the newly reduced insulin dose. The vet started out kinda concerned that he would be boarding but he seemed more relaxed after we talked. He said he liked Munchkin's bs readings. They will test bs before every shot and dose based on the reading they get.

I gave them conservative dosing instructions:
greater than 250, give 1.5 units
betweeen 200 - 250, give 1 unit
under 200, do not give any insulin

I didn't want to push it since they don't know Munchkin from a cat off the street. Do you think those dosing instructions are okay? I'll check in with them before we leave town and their office is open for business tomorrow so I can call and check on Munchkin then too. So, I'll talk to or see them again before leaving town, so I could tweak those doses if you thought it might be a good idea?
 
I do not think you are grasping at straws. I think things are gradually improving and that is great news!

I would also take some of the food for Munchkin to the vet and a card for them to put on the cage. Something like Diabetic cat FEED ONLY OWNER'S FOOD Lots of member's cats have had set backs because a vet tech just went through all the cages with a bag of dry food.......I like the choices for the dosing; it looks good to me.

It is wonderful that he came to you for a test. Amazing what treats can do!
 
Hooray! :RAHCAT Hooray!

Sooo glad you think this is progress too!

Yes, I took some of our low-carb canned food to the vet too, plus some extra. (Its probably just paranoia, but I take extra food just in case we are delayed or something unexpected happens - car trouble, illness & unable to travel, etc.) Sorry I forgot to include that earlier, but thank you for checking. However, I didn't take them a sign to put on the cage or anything like that. The girl who was writing down the instructions had a card, and I'll ask and see if that is what it was for. (I had taken written instructions but she copied them onto two different docs, including that card)

Munchkin is such a funny guy. He's so motivated by food and treats! He was mad this morning when I put him in his carrier; he pouted. I offered him some treats and he tried to pretend like he was too mad to want them, but he wanted them too bad and ate them anyways. LOL!
 
Back in town today but not picking Munchkin up until late this afternoon. The vet's office said he did well and wasn't too grumpy. They also said they kept bs records so I'll hopefully be able to load those readings tomorrow morning. I did pick up some u100 syringes to maybe try (with conversion chart).
 
Well, it didn't go as well as I had hoped, but nothing really went wrong, I guess. Munchkin boarded okay but they didn't give his AM shots until +14, and so the PM shots were off too at +10. We're trying to get back on a workable schedule over the next few days. So much for never breaking 400 on a bs test! They didn't know how to use my meter so they used the office Alphatrack instead. (They showed my meter to the techs when I checked in and no one had any questions then :-x ) Maybe that can account for some of the bs test result variances, but not all. Poor Munchkin was stressed out. Also, I don't think they did ear checks. I am not for sure but his ears don't look like they've been tested. All-in-all their office did okay, just not as well as I had hoped.

But, we had a more typical number this AM - 275, and gave his regular dose. Maybe we'll get back on track sooner rather than later.
 
Hi Rebekah,

I think I am using the same meter as you are. Sue you would know! LOL Sorry it is not in front of me and I too tired. If you have the same one...do you just put the testing strips in it, Drop blood and then the number comes up? That is how mine works. I have a Relion one...but I know they make different ones. If you have the same as me...I was just puzzled why the VET didn't know how to use it...

Either way though, glad munchkin is back on schedule. If we use the same materials, I would love to converse with you about them...

I wish Kolbie was as cooperative as your kitty! @-)
 
Looking at the ss, he is getting nice preshots, Rebekah. It will be nice for you to get some nadirs this weekend. Then we'd know if the dose needs tweaking.
 
Looking at the ss, he is getting nice preshots, Rebekah. It will be nice for you to get some nadirs this weekend. Then we'd know if the dose needs tweaking.
 
Well, I forgot Munchkin's meter at the house again. I think I can remember his readings for last night and this morning: 291 PMPS and 275 AMPS? Maybe. Either way it wasn't super high but still high enough to give him 1.5 units. Sue, I'm liking these pre-shot numbers too! :smile: I should be able to get more test values this weekend and try for a nadir or two.

We go on Saturday afternoon to a different boarding facility (Canine Clubhouse) so I can show the owner (Kim) how we do our home testing. She wasn't available to talk with me last week so we didn't board there last weekend. But after talking with Kim yesterday, it turns out they did have a diabetic kitty who home tested and boarded with them off and on for years! So, they've done home testing before, its just that they did it on that kitty's paw pads, not ears. Kim also said with their operating hours they'd be able to do all Munchkin's shots 12 hours apart. :-D I'm SOOO excited to have found a boarding facility that has done home testing before, and on a better schedule than the vet's office!

I'm not sure which ReliOn meter I have either, maybe the Prime? No matter which one it is, you are right, they are so easy to use. I didn't understand either why the vet tech didn't know how to use it, and we asked too. Still, I'm grateful they agreed to board Munchkin. Very thankful! And the vet was awesome too! They could have just refused to board an unfamiliar, "high-risk" cat. I would have really been in a pickle then!

Ha, Ha! I don't think anyone who has met Munchkin has described him as "cooperative". :lol: Grouchy, yes. They even commented on it on Monday when we picked him up from boarding. But, he's a mama's boy too and a big baby - when he's not mad!
 
Well believe me...my Vet has always been very nice about using words to describe how Kolbie was...but cooperative, had a good day...good...or anything like that has never come out of her mouth! Hahaha He is a huge mamas boy and gets grouchy with me too. He growls worse than the dogs but I ignore it. He thinks he big and bad... LOL
 
I updated Munchkin's spreadsheet; remembered to bring the meter with me today. Got a blue number this morning :smile: and did not give a shot. Very curious now to see what nadirs will be this weekend. Any ideas what dosing I should do this weekend, if I get some middle of the road numbers, or low-ish numbers?
>250 = 1.5u
200-250 = 1.0u
1??-200 = ?.?u
 
It looks like the shot is an hour early this am since you shot an hour late last night? That is probably part of the low number, but it is still nice and low. What a nice number to see!

First, expect a high number tonight because he will have been 24 hours without a shot. But I wouldn't shoot a high dose - maybe 1.2 or 1.5. Then it may take a cycle to get back on track. If I were you, I'd get a curve this weekend and see what he is doing. And probably yes, time to lower those doses a smidgen. Maybe 1.25 ( can't remember if you have U100 needles) if you can eyeball it for That 250 range. If you have U100s, maybe .8 for the 200 range. (be sure to use the conversion chart)

So, just a little bit until we see the nadir. If he is going down into the 60s at nadir, we might think a bigger reduction. If he surfs along and doesn't dip low, maybe less of a reduction. Since you are not home during the day, you have to be more cautious than if you were there to catch and take care of a low number.
 
Nope, not an hour early this AM! :smile: We are still working our way back to our normal schedule, so that was a bit of a hiccup last night - me being late. But, I was still able to give this morning's shot at +12, right before I left the house rather than in the middle of getting ready.

I'll expect a high reading tonight and probably give his regular dose of 1.5u, or 1.4u. I do have some u100 syringes and the conversion chart, but I haven't really studied up on them yet. I'll study up tonight. ;-)

So you think I should go ahead and lower the dose a little (1.5u --> 1.25u or 1.2u tomorrow morning if >250) even though we haven't seen the nadir? I was hoping to stick to the 1.5u dose through tomorrow and for the curve on Saturday (barring any readings <250). I want to see what the "typical" curve would look like to better be able to adjust his dose, rather than adjusting it now and having a curve of crazy readings on Saturday. If I end up with wild readings I won't have a chance to re-do the curve until a week later on the following Saturday.

But, I recognize that he might have bounced a little during the day yesterday, but it could have just been the dose being late by an hour too? I certainly don't want him too low while I am not there. And, I if I take him too low I could end up with a usless curve like our last curve on that Saturday two weeks ago. I know I am probably too close to the situation to give a completely clear assessment so I'll trust what you recommend. Let me know if I am understanding correctly the new doses to start tomorrow morning:
>250 = 1.25u or 1.2u
200 - 250 = 0.8u
<200 = no dose
 
Ok, I talked myself into that dose reduction, starting tomorrow AM. Sue, just let me know if I understand the new doses correctly (as above).
 
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